Author: Jason Zaremski, MD
Co Author #1: Daniel C. Herman, MD, PhD, CAQSM
Co Author #2: Thomas W. Wright, MD
Editor: Katerina Backus, MD
This is a 15 year old male right hand dominant catcher that presented with right elbow pain and weakness.
The onset was insidious with the mechanism of injury due to throwing. Initially, the patient was diagnosed with a reported non-displaced medial epicondyle avulsion fracture avulsion from an outside location 6 months prior. He stopped all throwing activities before returning to his high school baseball team 6 months later without a throwing program. He experienced pain throughout the throwing cycle diffusely about his elbow intermittingly for three months without any improvement in pain. He also began to experience occasional numbness and tingling in his right flexor forearm that spring. Symptoms improved at rest and worsened with throwing. He attempted rest for a few weeks, used ice, and tried acetaminophen and non-steroidal anti-inflammatory medications without improvement.
Upon initial examination in our clinic the patient had complete active range of motion about his shoulder and elbow, was tender to palpation over the ante-cubital fossa as well as just medial and lateral to this region, and had slight weakness with wrist flexion and radial deviation. Finger flexion, pronation and supination strength was normal though there was mild pain with pronation resistance. Sensory examination was normal throughout the right upper extremity and symmetric to the left arm.
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